Treating Osteoporosis In Men

DR. PAUL DONOHUE GOOD HEALTH

May 22, 2006|Dr. Paul Donohue

Dear Dr. Donohue: I am a 63-year-old male. Through an osteoporosis screening test on my ankles, it was determined I had a T-score of -2. That indicates osteopenia. I am planning on having the full-blown density tests. What is the difference in treatment of osteoporosis in men? At what T-score is medicine prescribed? My wife takes Fosamax for osteoporosis. Could I take the same medicine? -- B.G.

Dear B.G.: Say "osteoporosis" and the mental reflex "woman's illness" kicks in. More women have it than men, and that's partially due to the sudden drop in estrogen production with menopause. However, men are not immune to it. Men, throughout life, have thicker bones than women, and men don't have a precipitous drop in male hormone production like women do with female hormone production, so they are less prone to osteoporosis. About one-quarter of elderly men are in the same danger of breaking bones as are osteoporotic women. The bones most susceptible to breaking are the backbones, hips and wrists.

The T-score compares the density of a person's bones with the density of bones when they are at peak strength. A score of -2.5 or lower is osteoporosis. Your score of -2 signifies osteopenia, bones that have lost calcium and are not as robust as they should be.

DEXA (dual-energy X-ray absorptiometry) is the standard osteoporosis test. Readings are taken at the hip and lower back. Many wait until the DEXA T-score is -2.5 to begin treatment; others start sooner.

Treatment for men is the same as treatment for women. Vitamin D, calcium and exercise are important. The daily calcium intake should be 1,500 mg.

Bisphosphonates such as your wife's Fosamax work for men, too.

Dear Dr. Donohue: How is it possible for me to jump from 185 pounds to 225 pounds in one week? I watch what I eat. -- C.W.

Dear C.W.: It's impossible to put on 40 pounds of fat or muscle in one week even if you don't watch your diet. That added weight could be fluid, and that's an enormous amount in one week. If the scale is accurate and if this gain is fluid, you should have swollen ankles and a hard time breathing. You need to have your doctor take a look at you right away. A bad heart or bad kidneys or bad liver can make you retain fluid.